By Dr. Michelle Pearlman,
Irritable bowel syndrome (IBS) affects 10 to 15% of those in North America, and is more common in women than men. This uncomfortable and often embarrassing condition can be exacerbated by stress and dietary changes.
There isn’t a test for IBS. Gastroenterologists make the diagnosis based on the Rome IV criteria. Patients who experience at least two of the following symptoms are considered to have IBS:
- abdominal pain related to defecation or bowel movements
- a change in stool frequency
- a change in stool appearance at least one day per week for the past three months
If you were diagnosed with irritable bowel syndrome within the last few years, you’re familiar with how your GI tract typically responds to emotional stress, certain foods, and other triggers.
Let’s say your most recent exams and tests were normal. Your bloodwork ruled out celiac disease and giardia parasite. Your thyroid test and stool test (fecal calprotectin, which is a marker of intestinal inflammation) were all normal.
There are certain alarm symptoms that would lead me to recommend further workup.
- Rectal bleeding or black stools
- Diarrhea that wakes you up in the middle of the night
- Abdominal pain that gets worse with time
- Weight loss you can’t explain
- Someone in your family has a history of inflammatory bowel disease (like ulcerative colitis or Crohn’s disease)
- Someone in your family has a history of a gastrointestinal cancer (like colon cancer)
If your previous workup was completely normal and you don’t have any of these alarm symptoms, I recommend you focus on some nutritional changes that can help manage diarrhea.
I'd like you to increase your consumption of fiber, but not all fiber is created equal. Focus on foods high in soluble fiber. Soluble fiber helps bulk up the stool and slows down the digestive tract, so it can really help with the diarrhea.
The timing of liquids is also very important. I recommend that you drink the majority of your liquids between meals and drink only sips with your solid food. If your diarrhea is profound and has a lot of volume and frequency, then I recommend sipping on something like an oral rehydration solution (like Pedialyte). It has the optimal ratio of sodium and glucose to really help. Consuming excessive liquids that are too high in sugar or salt, or just plain water, can actually worsen diarrhea. Pay attention to any supplements that you’re taking. Many of the “calming teas” and other teas that people take to help with GI distress often contain laxatives and other additives that can worsen diarrhea.
“When the COVID-19 epidemic began, there was a lot of concern among patients and their treating physicians about whether patients who had IBD would be particularly susceptible to COVID-19, either as a result of having intestinal inflammation or as a result of the medications that they were taking,” said study senior author Maria T. Abreu, M.D., director of the Crohn's & Colitis Center. Read more.
There’s also growing reports of gastrointestinal (GI) symptoms common among those infected with the virus. What symptoms should people look out for? Learn more.